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Meconium-stained amniotic fluid as a predictor of poor outcomes in gastroschisis. J Pediatr Surg 2018 Sep;53(9):1665-1668 PMID: 29803305

Pubmed ID

29803305

Abstract

OBJECTIVE: The aim of this study was to determine if meconium-stained amniotic fluid (MSAF) was associated with neonatal outcomes in gastroschisis.

STUDY DESIGN: A retrospective chart review of gastroschisis patients from 2000 to 2014 at a single, tertiary institution was performed. Statistical analysis was performed with Fisher exact test, Welch's t-test, logistic regression and/or linear regression with significance at p < 0.05.

RESULTS: Sixty-four of 135 (47.4%) gastroschisis patients had MSAF. On univariate analysis, patients with MSAF were more likely to require staged closure (30 (46.9%) vs. 18(25.4%), p = 0.012), had more ventilator days (8.9 ± 11.1 vs. 5.3 ± 6.3, p = 0.021) and longer times to commence enteral feeds (24.9 ± 21.7 vs. 18.5 ± 14.5, p = 0.045). However, multi-variate regression analysis controlling for the type of closure, showed that delayed closure, but not MSAF, was associated with worse outcomes.

CONCLUSIONS: In gastroschisis patients, MSAF is associated with delayed closure but is not associated with outcomes independent of closure type. This association may be because of the matting of the bowel or increased intestinal damage. The MSAF status will aid in setting expectations for parents during their initial NICU stay and further investigation is warranted.

TYPE OF STUDY: Clinical Research Paper Level of evidence: III.

Author List

Koehler SM, Loichinger M, Peterson E, Christensen M, Szabo A, Wagner AJ

Authors

Erika Peterson MD Associate Professor in the Obstetrics and Gynecology department at Medical College of Wisconsin
Aniko Szabo PhD Associate Professor in the Institute for Health and Equity department at Medical College of Wisconsin
Amy Wagner MD Associate Professor in the Surgery department at Medical College of Wisconsin




Scopus

2-s2.0-85047296681

MESH terms used to index this publication - Major topics in bold

Amniotic Fluid
Female
Gastroschisis
Humans
Infant, Newborn
Linear Models
Logistic Models
Male
Meconium
Prognosis
Retrospective Studies
jenkins-FCD Prod-299 9ef562391eceb2b8f95265c767fbba1ce5a52fd6